Teaching the Prescriber’s Role: The Psychology of Psychopharmacology
The last two decades marked incredible advances in the neurobiological sciences. Psychiatric residents must master an increasingly complex body of neurobiology and psychopharmacology, prompting greater focus on the teaching of these and related fields. With limited time and resources in residency, there is relatively less time for teaching psychological and psychodynamic principles and the skills of long-term psychotherapy (1). With an increasing medicalization of psychiatry, influential academicians have seriously proposed that psychotherapy training be eliminated from training programs altogether (2, 3). However, the Accreditation Council for Graduate Medical Education (ACGME) has simultaneously emphasized the need for psychiatry trainees to develop competencies in psychotherapy and in the combination of medications and psychotherapy. One reason for this is the general agreement among training directors (4) that understanding intra-psychic and interpersonal dynamics is crucial for the functioning of all psychiatrists, even those focusing solely on somatic treatments. Nevertheless, while considerable effort has been put into better understanding and teaching what to prescribe, our field may have neglected a focus on how to prescribe. In this article, the author discusses the importance of psychological and relational aspects of prescribing for the trainee, both in relation to the resident’s development and efficacy as a biological psychiatrist.